Archived: West House Care Home

Updated 17 August 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 9 June 2015 and was unannounced.

The inspection team consisted of four adult social care inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for a person who uses this type of care service. The expert by experience on this occasion had experience in providing care and support to older people.

Before the inspection we reviewed all the information we held about the service including notifications. We had also received information of concern from the local authority regarding care of people who lived the home, safety and suitability of the premises and record keeping in relation to people’s care. We received information of concern form a visitor to the home, who told us people were not being cared for properly in an unpleasant environment.

We used a number of different methods to help us understand the experiences of people who lived in the home. Not all the people who used the service were able to communicate verbally, and as we were not familiar with everyone’s way of communicating we were unable to gain their views. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

During the inspection we spoke with 12 people who lived at the home and three visiting relatives. We also spoke with the acting manager, the team leader, and two staff.

We spent time looking at six people’s care records and a variety of documents which related to the management of the home, including, personnel files, staff training records and maintenance of the home.

Updated 17 August 2015

The inspection of West House Care Home took place on 9 June 2015 and was unannounced. We previously inspected the service on 15 April 2014. The service was in breach of the Health and Social Care Act 2008 regulations at that time.

West House Care Home is registered to provide accommodation and personal care for up to 37 older people. On the day of our inspection there were 27 people, many of who were living with dementia, resident at West House Care Home. The home provides accommodation on the ground and first floor.

The service did not have a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staffing levels were insufficient to meet people’s needs and staff did not all have the necessary skills to support people properly.

Staff lacked knowledge and understanding of the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). We saw evidence that people’s freedom of movement within the home was restricted by the use of locked doors. We were told that no DoLS applications had been made to the local authority in regard to the restrictions placed on people’s freedom. These examples evidenced a failure to comply with the requirements of the Mental Capacity Act 2005.

The premises had not been adapted to enable people who were living with dementia to live well. The home had bare décor, there was insufficient seating and the environment was not homely for people. Infection control measures were not sufficiently in place to ensure the home was clean.

There was a significant lack of sensory stimulation for people and people’s movement within the home was restricted by locked doors and lack of support to mobilise. There was limited evidence that people who lived at the home were purposefully engaged and people were bored.

Care records did not accurately reflect the care and support people required and there was a lack of dignity, respect and person-centred care, particularly in relation to people living with dementia.

There was no evidence that the registered provider had a system in place to evaluate and monitor the quality of the service provided to people or to respond to complaints.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

Ensure that providers found to be providing inadequate care significantly improve.

Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

You can see what action we told the provider to take at the back of the full version of the report.